Survey of Physician Attitudes Toward HIV Testing in Pregnant Women in Ohio

Abstract

HIV infection among women of childbearing age is still increasing in the United States. In most states, HIV testing of women or neonates during pregnancy is not mandatory. The current study assessed HIV prenatal testing practices among obstetrician-gynecologists and primary care physicians listed in a regional physician referral data base in a predominantly rural region. Between December 2000 and March 2001 a 20-question survey was sent by mail to regional physicians in obstetrics/gynecology and primary care regarding physician practice demographics and prenatal HIV testing practices. Of 1116 surveys sent, 431 were returned (38.6% response). Only 42% of physicians offered universal HIV prenatal testing. Factors associated with universal testing (p < 0.5) included obstetrics/gynecology as the practice specialty (90%) physicians' age younger than 50 years, and a practice with predominantly Medicaid or African American patients. Further educational and public health initiatives may be needed to increase nonselective, universal HIV testing in pregnant women.

Achieving Universal HIV Screening in Prenatal Care in the United States: Provider Persistence Pays Off

“…Providers' reports of the percentage of patients tested are similar to the percentages reported in surveys of women receiving prenatal care in a number of locations, [10][11][12] which was about 60%-80% during this time period. However, our findings are in contrast to other analyses in suggesting that testing among pregnant women has been higher in public clinics, and when funded by public sources such as Medicaid.…”

“…Specially designed follow-up procedures used in this survey resulted in an overall response rate of 70%, 5 whereas previous studies have had rates of 50 percent or less. 3,10,15,16 Moreover, because the survey had a probability sampling design, it has the advantage of providing estimates that are generalizable to the populations of care providers covered in each area. Furthermore, this approach provides a look at the variability of HIV testing practices in differing geographic areas, each of which has been strongly affected by the HIV/AIDS epidemic among women of childbearing age.…”

Attitudes About Prenatal Hiv Testing in Turkey

“…17 There is no world-wide prenatal testing practice. [18][19][20][21][22][23][24][25][26] Every country has different policies on this issue. However, whether or not there is a high infection rate, it is important to provide information about the disease and testing, including prevention and early diagnosis.…”

Successes and Challenges in the Perinatal HIV-1 Epidemic in the United States as Illustrated by the HIV-1 Serosurvey of Childbearing Women

“…While obstetricians and pediatricians seem to have a high degree of understanding of the importance of HIV-1 screening for prevention of MTCT, as many of 40% to 50% of physicians do not offer universal testing to pregnant women or, when the mother has not been tested, to their infants. [39][40][41] Reasons frequently given for the lack of testing include low prevalence of HIV-1 in the physician's practice; the perceived absence of "risk factors" for HIV-1 infection in the patient population; and lack of sufficient time for counseling the mother prior to HIV-1 testing. In New York State, the approach has been to encourage voluntary prenatal testing and to initiate mandatory newborn testing to capture those women who were not tested antenatally (although Pulver et al 19 note that when women had the option to receive the newborn result or not, 90% of women opted to learn the test result).…”